microsoft powerpoint - whf_medfundamentals

The text and photographs contained on this diskette are copyrighted and registered with the United States Copyright Office and may not be duplicated or modified in any way nor can a portion of any size be incorporated into the work of another without prior written consent of the author, the Women’s Heart Foundation. Copyrights © WHF1999 All Rights Reserved. WHF, P.O. Box 7827, Trenton, NJ. 08628. www.womensheart.org Rel 2004-07

presents

Medication Safety

Facts, Fiction & Fundamentals

What everyone needs to know when taking medicines and supplements

Medication Safety Week is April 1-7FOCUS DAYS:

1. Clean out your medicine cabinet day2. Know your medicines awareness day 3. Read medicine labels carefully awareness day 4. Dietary supplements awareness day5. Organize your medicines awareness day6. Transitional care awareness day7. Better communication with health

professionals awareness day

The Women’s Heart Foundation Champions of prevention and wellness programs for improving women’s survival and quality of life

The Women’s Heart Foundation, the only non-governmental organization that implements demonstration projects for the prevention of heart disease, is a 501c3 charity dedicated to implementing wellness and gender-specific evidence-based medicine.

Founded 1986. Incorporated June 11, 1992

Discussion of herbs and supplements does not imply endorsement of their use.

What may be advocated for the general population may not be right for you.

Before considering taking a dietary supplement, consult with your primary care doctor or practitioner who can address your personal healthcare needs.

WHF Disclaimer

A message from Honorable Governor Christie Whitman

• Use medicines wisely• Read labels carefully• Be careful when taking

supplements• Report side effects

promptly• Don’t hesitate to ask any

questionsMedication Safety…

it’s everyone’s concern!

Defining the Problem• The FDA estimates that 76.6 billion dollars is spent

annually on preventable medication-related illnesses.• 25% of all hospitalizations among the elderly are due

to medication-related illnesses.• 30-50% of people take their medicines incorrectly.

Over 60% don’t inform their doctors if using complementary medicine.

• Unsafe use of medicine affects survival and quality of life.

1998 Article in the Journal of American Medical Association

• 100,000 hospitalized patients in the U.S. die each year of adverse drug reactions.

• This problem is between the 4th and 6th leading cause of death.

• Another 2 million patients experienced serious reactions, causing permanent disability or resulting in death.

• These figures do not include less severe or outpatient reactions.

Goals of the Medication Safety Campaign

• Raise awareness about safety issues regarding use of medication and supplements.

• Offer specific strategies to reduce risk.

• Make everyone more comfortable discussing medicines and supplements.

Objectives of theMedication Safety Campaign

By the end of this program, participants will be able to:

• Complete a medication record.

• Fill a medication organizer box.

• Have a better understanding of generic drugs and supplements.

Definitions• Generic drug: a drug that has the same active

chemical ingredient as a “brand” name drug but usually costs less.

• Dietary Supplements: products that people use in addition to the foods they eat (e.g. vitamins, minerals, herbals, etc.).


3 Scenarios

“I didn’t tell my doctor

I was taking supplements because she

would not approve”

If you plan to use a supplement, discuss it with your doctor or practitioner.

“I take this little white pill

for my heart”

Ask for both generic name and brand name for each pill prescribed to be written down on the instruction sheet. Ask the pharmacist to write on the medicine bottle both names and what the medicine is for.

“My wife thought taking a

supplement was safe

because it was natural”

Ephedra is a “natural” stimulant that can be deadly.

Ask your pharmacist…

• For the printout sheet for each medicine that you take.

• For both the generic name and the brand name to be printed on the label.

Captopril 12.5 mg. Take 1 pill three times a day. For blood pressure(Generic of Capoten)

For example…

Safety Rules When Taking Medicine

Make a list of your medicines. Include over-the-counter drugs, birth control pills, vitamins, herbals and other supplements.

Keep the list updated.Keep the list with you at all times.

More Safety Rules When Taking Medicine

• Read labels carefully.• Keep medicines organized and out of reach.• Discuss use of a supplement with your

primary care doctor or practitioner beforestarting it.

• If you have any questions – ask your practitioner or pharmacist.

More Safety Rules When Taking Medicine

• Be aware of possible side-effects. • Report side-effects to your doctor or

practitioner and pharmacist promptly.• Store pills in their original containers and in

a cool, dry area.• Discard outdated pills.

Double Check Your Medicine…• When picking up a new or refilled

prescription.

• After a visit to your doctor.

• While in a hospital or nursing home.

• When being discharged from a hospital or nursing home.


Part IIMedication Safety Alerts

Medication Safety Alert• Beware of pills that Look Alike but are

different.

• Beware of pills that Look Different but are alike (the same active ingredient in generic form) .

• Beware of medicines that Sound Alike but are different.

Drugs That Look AlikeBut Are Different(different dosages)

Halcion®

Reprinted with permission. USP DI® Volume II “Advice for the Patient® Drug Information in Lay Language”

Different doses that look the same

Arthrotec®

Different doses that look the same

Viagra®

Drugs that Look Alikebut are Different

(All are small white pills)

Clonidine(lowers bloodpressure)

Albuterol(breathing pill)

Furosemide(water pill)


Drugs that Look Different but are Alike (generic forms)

All are Clonidine – a drug used to lower blood pressure


Note that the color order is different for each of the 4 manufacturers

Drugs that Look Different but are Alike (Generic forms)

Note how shades of peach, purple and pink are harder to distinguish from one another.

Decadron® Dexamethosone


All are Dexamethasone - a corticosteroid

Note the color order is different

Drugs With Names That Sound Alike

• Cerebyx - Celebrex - Celexa

• Hydroxyzine - Hydralazine

• Clonidine - Klonipin

• Xanax – Zantac

Medication Safety AlertGender Differences

• Men and women are affected differently by medications.

• Although much is known about the way men react to certain medication, there are many unanswered questions as to how women respond to similar medicines. Research is providing new information.

Graphic by Dave Clawson. © 1999 WHF


Part III

Dietary Supplements and Medication Safety

Megadosing• Can have a negative effect on health.

• As a general rule, don’t exceed 300% of the Recommended Daily Allowance (RDA).

• Always check with your pharmacist.

Are Vitamin Supplements Beneficial?

• B Vitamins (B-6 and Folate)• Vitamin C• Vitamin E

More study is needed

Commonly Used Herbal Supplements

• Black Cohash

• Chamomile

• Don Quai

• Echinacea

• Evening Primrose

• Feverfew

• Flaxseed / Flax Oil

• Garlic

• Ginger

• Gingo Biloba

Commonly Used Herbal Supplements

• Ginseng

• Gotu Kola

• Green Tea

• Kava Kava

• Peppermint

• Soy products

• St. John’s Wort

• Valerian

Medication Safety AlertIf pregnant or breastfeeding…

• Do NOT take Herbals while pregnant. Some Herbals can cause spontaneous abortion.

• Do NOT take Herbals while breastfeeding. Herbals can pass to the baby in breast milk.

Pictograms reprinted with permission. The United States PharmacopeialConvention, Inc. © 1997 All rights reserved.

Medication Safety AlertBeware of giving Herbals to children• s • Check with your child’s

pediatrician before considering any Herbal remedy for your child.

• Store medicine and herbals out of reach of children.

Pictograms reprinted with permission. The United States PharmacopeialConvention, Inc. © 1997 All rights reserved.

Medication Safety AlertDo NOT take Herbals before

surgery

• Stop all Herbals 2-3 weeks before a scheduled surgery.

per recommendation by the American Society of Anesthesiologists

Safety Rules if taking herbals

• Communicate! Studies show many patients don’t tell their doctors when they’re taking supplements, which can lead to problems.

• Check with your practitioner beforestarting on supplements, especially if you are being treated for any medical conditions.


• Avoid using Herbals if taking a medicine treating the same condition. “Double-dosing” can occur.

• Don’t assume that a supplement is safejust because it’s “natural”.


• The long-term effects of supplements affecting brain metabolism are not known (e.g. St. John’s Wort, Melatonin).

• Limit the use of these supplements to no more than 2-3 weeks.

Medication Safety AlertHerbals and Coumadin®

• DO NOT USE Herbals such as feverfew, garlic, ginko, ginger, dong quai, ginseng, or drink teas containing coumarin while taking Coumadin®(warfarin), as increased bleeding can be experienced.

• Check with your doctor, prescribing practitioner or pharmacist for more information.

Medication Safety AlertSt. John’s Wort

• It was recently reported that St. John’s Wort not only hampers the effect of AIDS drugs but also causes similar problems with heart drugs and antibiotics.

• For a listing of interactions, go to www.fda.gov/cder/drug/advisory/stjwort.htm

Medication Safety AlertGinseng

• DO NOT USE ginseng when taking estrogens or steroids because of possible additive effects.

Medication Safety AlertEphedra Warning

• The FDA issued a warning about Ephedra(a stimulant that increases metabolism and affects the cardiovascular system).

• Many deaths have been associated with its use.

What is Synergy?• Synergy is the combination effect of chemicals that

can yield a more potent reaction (e.g. alcohol + cold medication = drowsiness).

• Synergy gives cause for concern, especially when the cardiovascular system is affected.

• Use caution when taking medicines and supplements because combining them may produce unknown effects.

Synergistic effects of medicines and herbals

• Taking precautions with herbals and medicines can reduce risk, but an adverse reaction may still occur.

• Synergistic effects from mixing drugs and herbs are unpredictable.

• Individuals metabolize drugs differently.


Part IV

Action Plan to improve healthcare communication;lower risk of medicine error

Complete your medication record

Benefits of keeping a Medication Record

• Provides a quick way for health information to be shared. In an emergency it could save your life!

• Makes it easier for consumers to ask questions about medicines and supplements.

Medication Organizer Box

Photograph of medication box used with permission from Apex Medical Co.

Medication Organizer BoxPROS

• It’s useful if taking more than one pill at different times of the day.

• It can help a disabled person be more independent with medicine-taking.

CONS• It requires careful daily

monitoring.• Look-alike pills are

placed together• It should not be used

with certain medicines – check with your pharmacist.

Communication is key…

Make a list of your medicines and include over-the-counter drugs, birth control pills, vitamins, herbals and other supplements.

Keep the list updated.

Keep the list with you at all times.

Report adverse effects promptly.

Read labels carefully.

Be careful when taking supplements.

Always ask questions.

Communication is key…

Grateful AcknowledgmentWomen’s Heart Medication Safety Committee

Program Co-Directors Darlene J. Goldstein, M.D.Lyman Hunter, R. Ph.

Regional DirectorsKathleen C. Ashton, PhD, R.N. – Southern NJ Kris M. Olson, M.S., R.N., N.P., C – Central NJ

ConsultantsDonna M. Gerome, R.D.Joseph P. Schoen, R. Ph. Michael Curran, BSc(Hons) BA

Reviewed by Steven A. Samuel, MD, WHF Medical DirectorEdited by Bonnie Arkus, R.N.

Grateful Acknowledgment

Honorable Former Governor of New JerseyChristine Todd Whitman

U.S. FDA Office of Women’s Health

New Jersey Hospital AssociationNew Jersey Pharmacists AssociationLibrary Cooperative of New Jersey

Resources… for more Information

• Balch, J., MD & Balch, P., CNC, Prescription for Nutritional Healing, Avery Publishing Group, 2nd ed.,’97

• The German Commission E Monographs from the American Botanical Council (check your local library)

• Graedon, J & Graedon,T, Dangerous Drug Interactions. The Peoples Pharmacy

• Somers, E, The Essential Guide to Vitamins and Minerals • Tyler,V ,The Honest Herbal, NY Pharmaceutic Product

Press, ’94

Resources… for more Information

• Your doctor, nurse or pharmacist.• The company that manufactures the product.

A FREE Medication Record and Guide is available through the Women’s Heart Foundation pdf health library page at www.WomensHeart.org

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www.WomensHeart.orgWellness Communities – Prevention – Gender care

Medication Safety MattersTake Care of Your Heart

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